Entries in Newborns
(7)

George Doyle/Thinkstock(WASHINGTON) -- Most new moms hope to exclusively breastfeed their babies for at least the first three months, but a new study from the Centers for Disease Control and Prevention found that, for a variety of reasons, only about one-third of those moms fulfill that breastfeeding goal.

CDC researchers surveyed nearly 1,500 pregnant women on their plans for exclusive breastfeeding after their babies were born, and then followed up with monthly surveys throughout the next year. The scientists found that 85 percent of mothers planned to breastfeed exclusively for at least three months, but only about 32 percent were able to do so for the intended amount of time.

The American Academy of Pediatrics and the World Health Organization recommend that all women exclusively breastfeed for the first 6 months of babies' lives.

"While most of these women said they hoped to exclusively breastfeed for at least three months, very few actually succeeded in their goal," said Cria Perrine, co-author of the study and an epidemiologist in the division of nutrition, physical activity and obesity at the CDC. "There is obviously a huge disconnect between these women's intentions and how they're able to follow through."

Perrine said many hospitals might not be as supportive as possible in helping women achieve these goals. In the study, 15 percent of the women's babies had already been given some sort of supplement to their breast milk before even leaving the hospital, which can cause nipple confusion and make it difficult to breastfeed afterwards.

Moms who began breastfeeding within an hour of birth were more likely to breastfeed according to their goals. Those who already had at least one other child and those whose babies were not given supplemental formula feedings were also more likely to reach their exclusive breastfeeding goals.

Women who were obese, smoked or had a longer intended exclusive feed time were less likely to reach their goals, the researchers found.

The study's authors concluded that increasing Baby-Friendly Hospital practices, which include giving only breast milk to babies in the hospital, might help mothers reach their breastfeeding goals.

The Baby-Friendly Hospital Initiative is a global program sponsored by the World Health Organization and UNICEF. Its mission is to encourage hospitals to offer an optimal level of care for infant feeding by giving mothers information, confidence and skills to successfully initiative and continue breastfeeding their babies.﻿

iStockphoto/Thinkstock(BOSTON) -- Infants delivered via cesarean section have about twice the risk of becoming obese as infants delivered vaginally, according to a new study published in the journal Archives of Disease in Childhood.

Researchers recruited more than 1,250 pregnant women from the Boston area and followed their children until the age of 3.

They found that at age three, 15.7 percent of children delivered by C-section were already obese, while only 7.5 percent of children delivered vaginally were obese.

The mother's body mass index and the baby's weight at birth did not play a big role in predisposing children to obesity, the researchers explained. Previous research, however, has linked maternal obesity to obesity in their children.

Dr. Susanna Huh, lead author and an assistant professor of medicine at Harvard Medical School, said the findings still need to be confirmed in later studies, but they suggest that women considering having a C-section that isn't medically necessary should know that their children may be at higher risk for obesity.

"Almost one in three children are delivered by C-section in the U.S., and if cesarean delivery is a risk factor for obesity, this would be an important reason to avoid them if they aren 't necessary," Huh said.

The mechanism behind the relationship between C-sections and obesity is unknown, but Huh and her co-authors speculated there could be a few possible explanations.

"One possibility is that different modes of delivery may affect the bacterial communities established in the body at birth. This could affect obesity by affecting the absorption of nutrients from the diet, or the bacteria in the gut might interact with host cells in ways that promote obesity," she said.

"Another possible explanation is that hormones and protein signals released during labor may have an effect on the development of obesity," she added.﻿

Hemera/Thinkstock(NEW YORK) -- All newborns should undergo a standard screening for life-threatening heart defects, according to new recommendations published in the Lancet.

Researchers suggested that a pulse oximetry, a low-cost, non-invasive device that tests patients' blood oxygen levels, is more accurate at detecting such heart conditions than a standard clinical examination, and it should be used internationally as routine assessment in all newborns before they leave the hospital.

"The findings of this meta-analysis provide compelling evidence for introduction of pulse oximetry as a screening method in clinical practice," Dr. Shakila Thangaratinam, lead author of the study, wrote in a statement. "The sensitivity of the test is higher than present strategies based on antenatal screening and clinical examination, and the false-positive rate is very low, especially when done after 24 hours of birth."

The device showed an accuracy rate of 99.9 percent, and detected 76.5 percent of all congenital heart-defect cases and had a low false-positive rate of .14 percent. The findings were based on 13 studies that included nearly 230,000 newborn babies.

Congenital heart defects, or flaws in the structure of the heart and blood vessels, are the leading cause of death in newborns, but outcomes can drastically differ if the condition is found early and babies have corrective surgery quickly. The test is intended to detect critical congenital heart disease, not minor heart defects such as heart murmurs.

Since 2011, four states in the United States have passed laws that require newborns to undergo the basic test.

"I agree with the recommendations to use the low-cost screening test of pulse oximetry to help diagnose newborns with congenital heart disease," said Dr. Dennis Mello, director of pediatric cardiac surgery at Ochsner Medical Center in New Orleans. "Pulse oximetry, however, will not detect all patients with congenital heart defects. The cost of pulse oximetry is low and its use could be easily implemented in clinical practice."

Each test averages about $5 to $7 per baby, said Dr. Thomas Anderson, a pediatric cardiologist at The Children's Hospital of Philadelphia who is a proponent of the screening.

Anderson helped to implement the screening for all babies born in the state of New Jersey, the first state to pass legislation mandating the test.

"Since it went into effect in August 2011, we've screened about 50,000 to 60,000 babies," said Anderson. "These babies are ready to go home and look healthy and nice and pink, but then they have this underlying condition and these are the babies that collapse or go into shock and potentially die, so detecting these babies right upon birth is certainly beneficial."

Since New Jersey enacted its legislation, Indiana, Maryland and Virginia have followed suit, Anderson said. Most other states have legislative proposals in the works.

Anderson said some experts argued that false-positives will cause unneeded stress for families and the tests will add extra costs to a health care system that has an already-strained budget. But Anderson argued that the detection of severe heart disease in a baby before leaving the hospital eliminates other extreme costs, like emergency room visits and expensive surgical repair.

While nearly all U.S. hospitals already have the need testing equipment, many around the world are stretched for resources. Anderson said it is worth investing in the inexpensive device because of the potential lives saved and high costs avoided.

Photodisc/Thinkstock(NEW YORK) -- Pregnant women who take certain anti-depressants can significantly increase their chance of having babies that develop a condition known as pulmonary hypertension, according to a study published Thursday in the British Medical Journal.

An estimated one in every 1,000 babies born develop pulmonary hypertension, characterized by high blood pressure in the lung arteries, according to the American Academy of Pediatrics.

The condition occurs when newborn babies are not able to adapt to breathing on their own, which can potentially lead to organ failure and brain damage. On average, 11 percent of newborns diagnosed with this condition will die from it, according to the American Academy of Pediatrics.

The study suggests that women who took one of the most prescribed class of anti-depressant medications known as selective serotonin reuptake inhibitors (SSRI) during pregnancy were twice as likely to have their baby develop pulmonary hypertension compared with mothers who didn't take SSRIs.

But many experts said the risk is still low.

"You're doubling the risk of extremely low risk to again, an extremely low risk," said Dr. Marjorie Greenfield, division director of obstetrics and gynecology at University Hospitals Case Medical Center in Cleveland. SSRIs, more commonly known by their brand names such as Zoloft, Paxil, Celexa and Lexapro, are taken by 1.5 percent of pregnant women in the U.S.

The study reviewed six million births that took place from 1996 to 2007 in Denmark, Finland, Iceland, Norway and Sweden.

Study researchers said they took into consideration the mothers' health conditions such as obesity, diabetes, or behaviors such as smoking, or the way the baby was delivered. These factors have previously been associated to a baby's development of pulmonary hypertension.

George Doyle/Thinkstock(LONDON) -- Breastfed babies cry more than formula-fed ones, but that’s normal, so stick with it. Formula-fed babies may be quieter but overfed.

That’s the message the U.K. Medical Research Council wants mothers to take from a study published this week in the science journal PLoS One.

The British and U.S. governments recommend mothers exclusively breastfeed for the first six months of a child’s life. They cite research showing breastfeeding is healthier for babies and mothers. Some researchers even say it makes children, especially boys, smarter.

In both countries, official statistics show three-quarters of new mothers follow this advice, but many give up in the first few months, if not weeks. According to the latest U.S. data, 13 percent of those who tried completed the whole six months.

This means mothers perceive irritability as “a negative signal,” a Medical Research Council statement said, an interpretation perhaps few mothers would challenge.

However, “[R]ather than being a sign of stress, the researchers say irritability is a natural part of the dynamic communication between mothers and babies and should not deter women from breastfeeding,” the release continued.

And formula-fed babies, “may appear more content, but research suggests that these infants may be over-nourished and gain weight too quickly,” wrote the study’s lead researcher, Dr. Ken Ong, of University of Cambridge.

To study the link between infant temperament and feeding, the study asked mothers of 316 babies to rate their baby’s behavior at age three months. Compared with formula-fed babies, exclusive breast-fed and mixed-fed babies showed “greater distress,” “less smiling” and “lower soothability,” according to the article.

Susan Burger, PhD, president of the New York Lactation Consultant Association, faulted the study for assessing babies’ temperaments using mothers’ self-reported data but agreed with the study’s goal of giving mothers more realistic expectations as a way to bolster breastfeeding.

Madeline Mann. Loyola University Medical Center(MAYWOOD, Ill.) -- Two women who hold records for being the smallest surviving newborns are now doing fine and have developed normally, despite being born months premature and weighing about as much as a smart phone after birth, according to doctors where both babies were born.

Madeline Mann is now 20 and a college student. When she was born in 1989, at nearly 27 weeks, she was the world's smallest surviving infant at 9.9 oz. In 2004, Rumaisa Rahman, a twin, weighed just 9.2 oz when she was born at nearly 26 weeks and became the world's smallest surviving newborn. She still holds that record today.

In a follow-up study published in the journal Pediatrics, doctors at Loyola University Medical Center described the girls' progress since their birth. Both Madeline and Rumaisa developed normal motor and speech abilities and so far, have no chronic health problems. They are also both much smaller than peers their age.

In addition to being born extremely early, both babies were very low birth weight for their gestational ages. Normally, an 18-week-old fetus is around the weight they were when they were born. Although they are doing well, lead author Dr. Jonathan Muraskas, professor of neonatal-perinatal medicine at Loyola University Medical Center, stressed that despite their successes, Madeline and Rumaisa are very atypical of babies born that early and at weights that low.

"The normal outcomes that are somewhat of a miracle," said Muraskas. "We don't want the public to look at these two and have false expectations about outcomes."

"The vast majority of extremely pre-term infants who are also growth-restricted as these two were don't survive and those that do have major handicaps as well as ongoing health issues," said Dr. Deborah Campbell, director of neonatology at the Children's Hospital at Montefiore in the Bronx, N.Y.

Dominic Francis, a 2-year-old from Cincinnati, is living with some of these health issues. Though he wasn't born as early as Madeline or Rumaisa, he was only 29 weeks old and weighed a little more than two pounds at birth.

He developed cerebral palsy after he was born, and now has trouble walking and communicating.

While she's happy to hear about rare cases like Madeline and Rumaisa, Dominic's mother, Laura, also wants people to know they are the exception.

"The more common stories are the kids like my son who now face a lifetime of health and medical issues. I understand why the happy story gets the press, but the reality is that families of preemies have an uphill battle starting at birth," she said.

Jupiterimages/Thinkstock(WASHINGTON) -- The newborn death rate in the United States is higher than in 40 other countries including Malaysia, Cuba and Poland, according to a new study. The study, published in the journal PLoS Medicine, examines data from 190 countries, finding that newborn deaths have declined over the past 20 years from 4.6 million in 1999 to 3.3 million in 2009.

But despite the overall decline, infant mortality has dropped much more slowly than other age groups, accounting for 41 percent of child deaths worldwide.

While the infant mortality rate in the U.S. is high compared with other wealthy countries, 99 percent of infant mortality occurs in low-income countries. Just five -- India, Nigeria, Pakistan, China and the Democratic Republic of Congo -- account for more than half of the 3.3 million annual newborn deaths. India alone has more than 900,000 a year.